Mortality from short-term exposure to particulate matter, nitrogen dioxide and ozone across Europe

While the long-term health impacts of air pollution are well documented, the combined short-term mortality burden of multiple pollutants at the continental scale remains insufficiently quantified. Previous assessments typically assume uniform risks, overlooking geographic and demographic heterogeneity in vulnerability. Here using daily mortality and exposure data from 653 regions across 31 countries (2003–2019), acute exposures to fine particles (PM2.5), coarse particles, nitrogen dioxide (NO2) and ozone are each significantly associated with a 0.54–1.14% increase in mortality risk per 10 μg m−3. The multi-pollutant model estimates 146,517 annual premature European deaths (95% confidence interval 119,992–173,771) attributable to their joint short-term effects. Vulnerability is not uniform: younger males face higher mortality risk from particulate matter and NO2 than young females, whereas risks increase with age among elderly females. Uniform risk models underestimate burden in Eastern and Southeastern Europe. These findings reveal substantial geographic and demographic inequities in pollution-related mortality, with direct implications for air quality policy and public health early-warning systems. Short-term exposure to the air pollutants PM2.5, PM10, nitrogen dioxide and ozone was associated with increased mortality in an analysis of 88.8 million deaths in 653 European regions, with differences between sexes and countries.